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Failure to pump blood at a sufficient rate to meet the metabolic demands of the body
Heart Failure
Most common etiologies of Heart Failure
Coronary artery disease, Heart attack, Hypertension
Progression from hypertension to heart failure
Normal —> hypertrophic (chambers too small, muscle too big) —> dilated (myocyte death)
Impaired ventricular activity, increased afterload.
Left Sided heart failure
Mainly caused by Left sided heart failure, pulmonary embolism
Right sided heart failure
Major symptom of Left side heart failure
Shortness of breath
Sign of Right sided heart failure
Peripheral edema
Drugs for heart failure aim to block what?
Compensatory mechanisms (SNS, RAAS, Anti-diuretic hormone)
ACE inhibitors MOA
Inhibit Angiotensin converting enzyme
Spironolactone Drug type and MOA
Aldosterone antagonist, K+ sparing diuretic
Diuretic that works at the loop of Henle
Furosemide (Lasix)
Nitrates decrease what?
Pre-load
Hydralazine decreases what?
Afterload
Beta blockers result in what?
Decreased HR, Contractility = decreased oxygen and metabolic demand
Rarely prescribed anymore
Digoxin
Digoxin MOA
Inhibits Na/K ATPase pump
Why is Digoxin not preferred?
Low therapeutic index
Vasopressin (ADH) antagonist
Tolvaptan
Drug Acronym for Acute Pulmonary Edema treatment
LMNOP (Lasix, Morphine, Nitrates, Oxygen, Position)
What do ACE/ ARBS do to help heart failure?
Vasodilation = decrease pressure
What do diuretics do to help heart failure?
Decrease fluid = decrease swelling and pressure
What do beta blockers do to help heart failure?
Slow HR = decreased oxygen demand
What does Spironolactone do to help heart failure?
Reduce fluid retention by limiting aldosterone